Friday, March 20, 2009

The A, B, C and D’s of Medicare


This week, members of the Elder Economic Security team attended, “Medicare 101”, an event presented by the Kaiser Family Foundation and the Alliance for Health Reform. Here, we were reminded of the intricacies of the Medicare system, and reaffirmed our belief in the importance of this program for elder economic security.

Medicare is divided into 4 parts, and each caters to a specific benefit:

1) Medicare Part A: Hospital Insurance, this benefit is used to pay for inpatient hospital stays and hospice care.

2) Medicare Part B: Supplemental Medical Insurance, this benefit is used to pay for physician services, outpatient care by hospitals, and other services not covered by Part A.

3) Medicare Part C: Medicare Advantage, payment of care available through private plans.

4) Medicare Part D: Prescription Drug Benefit, payment of care available through private plans to cover Rx drug costs.

More can be done to improve the current Medicare system, which by the way currently supports 44 million beneficiaries, such as payment reform. This system is not perfect, and in desperate need of reform so that elders and others supported by the program can make the best choices at minimal cost. It looks to be at the forefront of the healthcare reform debate and we are anxious to see what changes are put forth during this Congressional year.

WOW supports strengthening Medicare becuase even with supplement coverage, the Elder Economic Security Standard™ Index demonstrates that elders continue to experience out-of-pocket expenses (between $250-300 per month) for health care. When in good health, health care is the second largest out of pocket expense for our elders. At WOW, we believe Medicare is a solid foundation on which to build universal affordable and accessible health care for all. That being said, WOW urges policy makers to not forget the struggles of underinsured Medicare beneficiaries when contemplating overall health care reform.

2 comments:

Stacy Sanders said...

When I think about the Medicare populations, a particularly vulnerable group comes to mind, namely those beneficiaries who were without healthcare coverage prior to enrolling in the Medicare system.

The 50+ population is most at-risk for chronic, pre-existing health conditions that make it difficult to attain health insurance. Often times, these individuals will go without coverage and appropriate care for many years. This leads to poor health consequences and increased costs to Medicare once they're finally able to access benefits at age 65.

This common circumstance highlights three important policy points: 1) how important access to Medicare can be, 2) how vital it is to strengthen Medicare coverage for chronic health conditions and 3) how necessary it is to assure universal access to health care coverage across the generations.

Martha Holstein said...

I wonder how many people who do not have first hand knowledge of the costs of health care for people who receive Medicare have any idea just how Medicare is just the beginning of adequate health care coverage. I think it is essential for us to get the word out that Medicare supplements cost $160 and more a month and the older one gets the higher the premiums. Then add to it the premium for Part D, the costs of prescriptions even with Part D, the deduction from social security for Part A,and the monthly costs out of pocket (even in the absence of a single medical bill can be between $260 and $360 or more a month (depending on drug costs and age)--and that is if one doesn't have any costs that were not reimbursed. If one is married the costs can exceed $700 s month. Medicare is not a free lunch! Efforts to reduce its coverage must be resisted. Ideally Medicare coverage should be expanded so that the need for supplemental policies is gradually phased out.